Caring for Someone with Progressive Dementia

What is progressive dementia?

Progressive dementia is the gradual loss of mental functions such
as the ability to think, reason, remember, and plan. Dementia is
caused by damaged brain cells. A stroke, brain tumor, head injury,
or disease, such as Alzheimer's or Huntington's disease, can
damage brain cells. Dementia is more common in older adults.

People with dementia have trouble with things such as:

putting thoughts into words or responding to others

understanding complex information

reading and writing

learning new things, for example, remembering directions to
new places

remembering how to do things, such as how to cook something

remembering things that just happened or things that have just
been said

concentrating and paying attention

organizing, reasoning, and solving problems.

In the early stages of dementia, people can follow routines that
are familiar to them. As the disease continues, people have
serious problems with thinking, judgment, and the ability to do
everyday activities. In time, people may be totally dependent on
others for care. Their personality also changes.

What should I do as a caregiver?

If you are caring for a person with dementia in your home:

Keep routines and the surroundings as much the same as
possible. Try to understand their past experiences and habits.
Make current routines as much like the past as possible.

Only do for them the things that they can no longer do.

Find and remove home hazards, such as throw rugs or poor
lighting.

Allow lots of time for communication.

Speak slowly and simply. Repeat or rephrase your message.

Ask questions that can be answered with yes or no.

Listen to what the person with dementia is saying. Try to
understand the feeling behind the person's words. Don't argue
with the content of the person's thought. Agree with the
feeling.

Give choices, but limit the number of choices to two. Too many
choices can be hard for people with dementia to handle.

Reduce distractions. For example, reduce background noise by
turning off the radio or TV when you need to talk to the
person, or when they must accomplish a task like eating a
meal.

Don't plan complicated trips. Short day trips to familiar
places can be fun. Long-distance travel is tiring and
disorienting.

Help the person give up driving.

Try to limit the number of new people that are around at any
one time.

Celebrate what they can do well. Don't focus on what they
cannot do.

How should I respond to a problem behavior?

Remember that problem behavior, such as arguing, pacing,
wandering, or resisting personal care, is a symptom of the
disease. Don't take it personally. Change the way you respond,
rather than trying to change the behavior. People with dementia
usually do not know that their behavior is inappropriate. The way
you respond can have a calming effect or make the situation worse.
Do not try to argue or explain what is happening. Rather, divert
their attention, stay calm, and reassure them.

Change any routines that may have started the behavior. Plan
events to be at the best time of the day for the person with
dementia. During stressful activities provide frequent breaks.
Offer snacks or return to a nonstressful familiar activity.

Change the surroundings if you think it may prevent a problem
behavior from happening. For example, a person who wanders may
need several types of locks installed on doors or a bolt put up
higher than expected.

When people with dementia cannot control unwanted behaviors,
divert them to something else. For example, say, "Let's do this
now, over here," rather than trying to tell them why they
shouldn't do something.

If the person with dementia seems to get worse over a few days,
with more disruptive and confused behavior, they may be getting
sick. As a caregiver, you should make sure that the person with
dementia sees their healthcare provider for a checkup. If you
notice something particular about the behavior change - for
example, it might be urinating in the wrong place more often -
tell the healthcare provider. Your information helps the provider
decide what testing to do.

What help is available?

Caring for a person with dementia can be a big challenge. It can
affect family life, careers, finances, and your mental and
physical health.

Find people who can help you. Nurses, adult day care, or adult
protective services may be available in your area. They may
include visiting services. Counseling may help you cope with
problems. Don't be shy about asking for help from friends or your
spiritual community.

When a family cannot keep caring for someone with dementia, other
options include residential care, such as nursing facilities.

For suggestions on ways for families to deal with dementia in
loved ones, contact the Alzheimer's Association at 800-272-3900 or
visit their Web site at http://www.alz.org. The local Area Agency
on Aging, which may be called something slightly different in your
area, can also provide information about available services. If
you have trouble finding the phone number for your local Area
Agency on Aging, call the toll-free Eldercare Locator phone
number: 1-800-677-1116.

Disclaimer: This content is reviewed periodically and is subject to
change as new health information becomes available. The
information provided is intended to be informative and educational and is not a
replacement for professional medical evaluation, advice, diagnosis or
treatment by a healthcare professional.